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Feb. 24, 2012 -- Knowing how to use a condom correctly -- and actually using it -- may mean the difference between life and death.

A new review of research shows errors in condom use -- such as putting it on too late, or not using condoms throughout sex, or not leaving space at the tip -- are common worldwide.

Researchers say the results suggest that user errors are a major contributor to condom failure rates, and millions of unintended pregnancies and sexually transmitted infections could be avoided by improved condom use.

"We chronically underestimate how complicated condom use can be," researcher Richard Crosby, a senior research fellow at the Kinsey Institute, says in a news release. “There is a complex triad of the sex act, condom use, and partner dynamics that must constantly be navigated by condom users."

Overall, the World Health Organization says condoms have a 2% failure rate when used perfectly and consistently. But the typical failure rate is much higher, at 15%, with the typical use of condoms.

Researchers say closing the gap between perfect use and typical use of condoms is a major public health issue for future condom promotion efforts.

Condom Use Errors Common

In their study, researchers analyzed 50 studies from 14 countries on condom use. The results appear in a special issue of Sexual Healthon condoms.

The review showed that although condom breakage and slippage were common issues in the studies, condom use errors were much more prevalent.

In addition, researchers say it’s probable that breakage and slippage often occur as a result of incorrect condom use. For example, one study showed the more condom use errors a person reported, the greater the odds of breakage, slippage, or both.

The most commonly reported condom use errors were:

Not using condoms throughout sexual intercourse

Not leaving space at the tip

Not squeezing air from the tip

Putting the condom on inside out

Not using only water-based lubricants

Incorrect withdrawal

Researchers point to a need for better education and instruction regarding how to use a condom.